Brain and spine care


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Brain and spine care

  1. 1. ( surgeries Microsurgery for Brain Tumors Endoscopic Brain Surgery Trans Nasal Endoscopic Brain Tumor Removal Skull Base Surgery Brain Trauma Surgery Congenital Cranial Deformity Stereotactic Brain Surgery for Tumor and FunctionalNeurosurgery
  2. 2. Craniofacial Surgery with FMS (Facio-Maxillary Surgery) Brain Surgery for Abnormal Blood Vessels, epilepsy,removal of blood clots Interventional/ Neuro-endovascular Therapy for Cerebro-vascular Diseases and TumorSpinal surgeries Spinal Decompression – microdiscectomy andlaminectomy Endoscopic spinal fusion Percutaneous Endoscopic Lumbar Discectomy
  3. 3. Total disc replacement surgery Spine Tumor Surgery Spine Trauma Vertebroplasty Kyphoplasty SpondylolisthesisSpinal Decompression Two general types of lumbar spine surgery comprise themost common surgical procedures for the lower back:Decompression and Spinal fusion
  4. 4. • Decompression surgery involves removing a small portionof the bone over the nerve root and/or disc material from underthe nerve root to relieve pinching of the nerve and provide moreroom for the nerve to heal(a MICRODISCECTOMY or LAMINECTOMY)• Lumbar spinal fusion involves using a bone graft to stopthe motion at a painful vertebral segment, which in turn shoulddecrease pain generated from the joint. Spine surgeryinstrumentation (medical devices), bone graft procedures, and thebone stimulator are sometimes used along with spinal fusionsurgery.
  5. 5. Lumbar Decompression Surgery Decompression is a surgical procedure that is performedto alleviate pain caused by pinched nerves (neural impingement).During a lumbar decompression back surgery, a small portion ofthe bone over the nerve root and/or disc material from under thenerve root is removed to give the nerve root more space andprovide a better healing environment.There are two common types of spine surgery decompressionprocedures: MICRODISCECTOMY (or MICRODECOMPRESSION) ora LUMBAR LAMINECTOMY (OPEN DECOMPRESSION).
  6. 6. Several conditions may cause neural impingement and necessitatethese surgeries, including spinal stenosis, a herniated disc, isthmicor degenerative spondylolisthesis, or a spinal tumor (rarely).How decompression surgery is performed With modern spine surgery techniques, both amicrodiscecto my and laminectomy can usually be done with aminimum amount of morbidity (e.g. post-operative discomfort)and a high degree of success in alleviating lower back pain and/orleg pain.Sometimes in addition to the decompression procedure, a spinefusion surgery is also necessary in order to achieve adequatedecompression of a nerve root. This is especially true if the nerveroot is compressed as it leaves the spine (in the foramen), knownas foraminal stenosis.
  7. 7. Foraminal stenosis is difficult to decompress simply by removingbone because if the bone is fully removed in the location of theforamen it is generally necessary to also remove the facet joint.Removing the facet joint leads to instability, so a spinal fusion isnecessary to provide stability.The foramen can be opened either through an anterior approach(by "jacking" open the disc space in the front of the spine) or bydistracting between two pedicle screws inserted posteriorly(through the back of the spine). After the foramen is opened up, aspine fusion is also done to keep it open so the instrumentationdoes not fail and the stenosis does not return later.As an alternative to spinal fusion, interspinous process spacers maybe implanted to open the central canal and foramen, and addressmotion restrictions and pain from spinal stenosis.
  8. 8. Microdiscectomy (microdecompression) spine surgery In a microdiscectomy or microdecompression spinesurgery, a small portion of the bone over the nerve root and/ordisc material from under the nerve root is removed to relieveneural impingement and provide more room for the nerve to heal.A microdiscectomy is typically performed for a herniated lumbardisc and is actually more effective for treating leg pain (also knownas radiculopathy) than lower back pain.Impingement on the nerve root (compression) can causesubstantial leg pain. While it may take weeks or months for thenerve root to fully heal and any numbness or weakness to getbetter, patients normally feel relief from leg pain almostimmediately after a microdiscecto my spine surgery.
  9. 9. How microdiscectomy is performed A microdiscectomy is performed through a small (1 inchto 1 1/2 inch) incision in the midline of the low back.• First, the back muscles (erector spinae) are lifted off thebony arch (lamina) of the spine. Since these back muscles runvertically, they can be moved out of the way rather than cut• The surgeon is then able to enter the spine by removing amembrane over the nerve roots (ligamentumflavum), and useseither operating glasses (loupes) or an operating microscope tovisualize the nerve root.• Often, a small portion of the inside facet joint is removedboth to facilitate access to the nerve root and to relieve pressureover the nerve.
  10. 10. • The nerve root is then gently moved to the side and thedisc material is removed from under the nerve root.Importantly, since almost all of the joints, ligaments and musclesare left intact, a microdiscectomy does not change the mechanicalstructure of the patients lower spine (lumbar spine).Indications for microdiscectomy surgery In general, if a patients leg pain due to a disc herniation isgoing to get better, it will do so in about six to twelve weeks. Aslong as the pain is tolerable and the patient can functionadequately, it is usually advisable to postpone back surgery for ashort period of time to see if the pain will resolve with non-surgicaltreatment alone.
  11. 11. If the leg pain does not get better with nonsurgical treatments,then a microdiscectomy surgery is a reasonable option to relievepressure on the nerve root and speed the healing. Immediatespine surgery is only necessary in cases of bowel/bladderincontinence (caudaequina syndrome) or progressive neurologicaldeficits. It may also be reasonable to consider back surgery acutelyif the leg pain is severe.A microdiscectomy is typically recommended for patients whohave:• Experienced leg pain for at least six weeks• Not found sufficient pain relief with conservativetreatment (such as oral steroids, NSAIDs, and physical therapy).
  12. 12. However, after three to six months, the results of the spine surgeryare not quite as favorable, so it is not generally advisable topostpone microdiscectomy surgery for a prolonged period of time(more than three to six months).Lumbar laminectomy surgery for spinal stenosis (opendecompression) A lumbar laminectomy is also known as an opendecompression and typically performed to alleviate pain caused byneural impingement that can result from lumbar spinal stenosis.A condition that primarily afflicts elderly patients, spinal stenosis iscaused by degenerative changes that result in enlargement of thefacet joints. The enlarged joints then place pressure on the nerves,and this pressure may be effectively relieved with thelaminectomy.
  13. 13. The lumbar laminectomy is designed to remove a small portion ofthe bone over the nerve root and/or disc material from under thenerve root to give the nerve root more space and a better healingenvironmentLaminectomy surgery The lumbar laminectomy (open decompression) differsfrom a microdiscectomy in that the incision is longer and there ismore muscle stripping.• First, the back is approached through a two-inch to five-inch long incision in the midline of the back, and the left and rightback muscles (erector spinae) are dissected off the lamina on bothsides and at multiple levels.• After the spine is approached, the lamina is removed(laminectomy), allowing visualization of the nerve roots.
  14. 14. • The facet joints, which are directly over the nerve roots,may then be undercut (trimmed) to give the nerve roots moreroom.• Post laminectomy, patients are in the hospital for one tothree days, and the individual patients mobilization (return tonormal activity) is largely dependent on his/her pre-operativecondition and age.• Patients are encouraged to walk directly following alaminectomy for lumbar stenosis. However, it is recommendedthat patients avoid excessive bending, lifting or twisting for sixweeks after this stenosis surgery in order to avoid pulling on thesuture line before it heals.
  15. 15. What is medical tourism? Medical tourism, also known as health tourism or health travel, isa term that describes travelling to a foreign country for medical,dental, or cosmetic treatment. It involves the benefit of costeffective treatment, private medical care, in collaboration with thetourism industry. The concept of medical tourism is fast growing inIndia and people from different part of the world are choosingIndia as their desired destination.Why Choose India?Medical tourism is a rapidly growing sector in India and millions ofmedical tourists from all over the world have come here toexperience a world-class healthcare service.In 2010, about 600,000 patients travelled to India from over 30countries for treatment, including the USA, Canada, UK, Russia, theMiddle East and Africa.
  16. 16. According to a study by the Confederation of Indian Industry (CII)on healthcare, after software, the medical tourism industry ispoised to be the next big success story in India. It has predictedthat the industry will grow to earn additional revenue of $2.3billion by 2012 and will soon account for a major share of thecountry’s revenue.There are several reasons behind this tremendous growth:Patients come to India to get specialized treatments not availablein their home country. Indian hospitals excel in performingcomplex cardiac surgeries, kidney transplants, bone marrowtransplants, orthopedic surgeries, infertility treatments amongsttheir wide repertoire.India provides world-class quality treatments at a fraction of thepriceof developed countries. The cost of medical treatment inIndia is generally one tenth of western countries and among thecheapest in Asia
  17. 17. India has state of the art medical institutes and hospitals ofinternational standards with highly qualified medical professionals.These centers are backed by high quality equipment andtechnology. This fusion of highly qualifiedstaff assisted by the latestequipment gives India the edge over other countries.With hospitals and clinics in every region including urban, semi-urban, or rural parts of the country, India has ample choice interms of preferred destinations.In countries such as Canada and the UK, patients almost alwayshave to wait weeks and sometimes months to avail of medicaltreatments. In India the consultations with the doctors are promptand patients receive a turnaround to their treatment plan at aquicker pace.
  18. 18. As English is a commonly spoken language in India, the patient willbe comfortable communicating with the doctors.Medical tourists find that the cost of their treatment (including thereturn airfare, holiday and accommodation) leaves them with atotal bill substantially less than they would have spent just onhaving the procedure in the UK.Why Arman There are several concerns that flicker in the minds of theforeigners who come for treatment to India, particularly for firsttime fliers. The first among them is which hospital to choose fortheir treatment.India is flooded with hospitals, medical centers and hotels whichhave their websites that attract the foreign patients.
  19. 19. This makes them even more confused and the complexity ofdecision making becomes a challenging task.We, at Arman can address all these concerns and issues by actingas intermediary with hospitals, clinics, surgeons, hotels.Arman is a healthcare facilitator that has painstakingly broughttogether highly qualified professionals and hospitals of repute andhealth care providers.We take the responsibility of screening the hospitals by checkingtheir track record, accreditations, associations and have partneredwith the best internationally accredited hospitals in India.Arman update and monitor our network of hospitals on a regularbasis and maintain a database on the hospital’s certifications, typeof facilities and other factors critical in choosing a medical center.
  20. 20. Arman also negotiate a lower price from the hospital which foreignpatients would not get by directly approaching the hospitals Thishelps the patient to save a lot on the medical procedure costsWe provide assistance with logistics, documentations, permits andother travel arrangements required for medical tourism.Our coordinators are highly trained to foresee every need of thepatient and make the entire process hassle free from start to finish.They help the patient plan his medical procedures before leavinghome, and schedules all his appointments, surgery, treatmentsand plans for recuperation.This in turn helps the patient to choose the hospital according tohis convenience and also get a clear picture of the cost oftreatment, accommodation beforehand that helps them toarrange their finance.
  21. 21. We are aware that a lot of trust is put in our hands and ensure thatthis trust is well placed by serving each patient individually withcare and comfort.How We Work Patient query received by the patient himself or his doctor/hospital.This query along with medical reports is forwarded to theconcerned hospitals to get expert opinionsAfter the hospitals respond, we create a package for the patientwhich includes recommendation on the treatments, duration ofstay, and the costs involved.The patient reviews the various options presented to him andmakes a decision based on budget and the line of treatmentrecommended by the doctors. Occasionally, a patient may clarifyhis concerns or questions he may have regarding the treatmentwith the doctor by telephone.
  22. 22. In liaison with the patients, Arman representatives will make priorbookings with the hospital, airlines, hotels.Patient travels and checks into hospital to start the treatment. Weprovide assistance through out your stay in the hospital whichinclude pre and post opeartive care.Once fit and able to travel, the patient if wishes can enjoy the vasttourist destinations within India before returning to their homecountry fully rejuvenated. (at an additionalcost)(ebranding/mum/ts/19)Arman Health Care FacilitatorsOUR OFFICE IN INDIA422, Bonanza, B Wing,Sahar Plaza Complex, Next to KohinoorHotel,Andheri Kurla Road, Andheri East Mumbai India 4000059.
  23. 23. Contact: land line No: ( 022-28387433 )Email :enquiry@armancare.comOUR OFFICE IN CONGOArman Health care Facilitators,Gallery Saint-Pierre, 36 localUtexAfrica Advanced ,AV 374 VolonelMondjiba,Kinshasa /Ngaliema,DRC Mobile : +243998290384OUR OFFICE IN KENYAArman Health Care Facilitators C/O Doctor Pharma Kenya LimitedVision Tower, Muthithi Road,Westlands, Nairobi,Kenya.Contact: Telefax:(+254)722330329Email : doctorpharmamt@gmail.comWeb:- ebrandingindia_s21